Risk factors for long-stays (more than 30 days) in Winnipeg hospitals were identified, including sociodemographic, illness, and system characteristics. The largest determinant of length of stay was discharge destination; discharge to a nursing home increased length of stay by 173% and 89% for medical and surgical patients, respectively. Hospital of stay also made a big difference for patients discharged to nursing homes. Only 13% of long-stay patients were discharged to a nursing home; 52% were discharged home. Other factors which were associated with an extended length of stay included, hospitalization for stroke, cognitive impairment, rehabilitation therapy, PEG tube insertion, and inhospital fall.